US update guidelines for statin use in people living with HIV

Simon Collins, HIV i-Base

New US guidelines for use of stain therapy in people living with HIV have been published based on results from the REPRIEVE study. [1]

These guidelines include a strong recommendation to start statin therapy among people living with HIH who have a 10-year ASCVD risk score of 5% or higher.

These were the participants in the REPRIEVE study who had the highest absolute benefit from statins.

Guidelines also favour a statin for people with a 10-year ASCVD risk score below 5%, but recommend discussions about risk that includes consideration for additional HIV-related factors that can increase ASCVD risk.

An accompanying editorial seems to emphasise that statin therapy alone will not be sufficient in older people, but unlike the main guidelines, this commentary is behind a paywall.

Reference

Beavers C et al. Statin Therapy as Primary Prevention for Persons With HIV: A Synopsis of Recommendations From the U.S. Department of Health and Human Services Antiretroviral Treatment Guidelines Panel. Ann Intern Med. doi:10.7326/ANNALS-24-03564. (27 May 2025).
https://www.acpjournals.org/doi/10.7326/ANNALS-24-03564
Amy Justice, Matthew Freiberg. Statins May Be Necessary but Are Not Sufficient for People Aging With HIV. Ann Intern Med. doi:10.7326/ANNALS-25-01463.
doi.org/10.7326/ANNALS-25-01463

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